Organization Active NPI

Healthsource of St Paul

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1609106582
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
547 Issued in MN
Legal business name
HEALTHSOURCE OF ST PAUL
Practice address
1815 Suburban Ave
Saint Paul, MN 55119-4302
Phone
(651) 731-1880
Fax
(651) 739-6029
NPI assigned
Dec 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James Buesgens, DC,OTR
Title
Chiropractor
Phone
(651) 731-1880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 547 MN Primary

Addresses

Primary practice location

1815 Suburban Ave
Saint Paul, MN 55119-4302

Mailing address

1815 Suburban Ave
Saint Paul, MN 55119-4302
Phone (651) 731-1880

Other identifiers 1

IdentifierTypeStateIssuer
547OtherMNPROFESSIONAL FIRM LICENSE

National Provider Directory

National Provider Directory

Locations

1815 Suburban Ave
Saint Paul, MN 55119
Phone (651) 731-1880

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1609106582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SUBURBAN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194302",
            "telephone_number": "651-731-1880",
            "fax_number": "651-739-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 SUBURBAN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194302",
            "telephone_number": "651-731-1880",
            "fax_number": "651-739-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF ST PAUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "BUESGENS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "651-731-1880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC,OTR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL FIRM LICENSE",
            "identifier": "547",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.